Effective January 24, 2022

These Medication Service Terms (“MS Terms”) govern your use of the Medication Service, which includes connection to the Surescripts Service (defined below).  These MS Terms are incorporated into the Builder Terms, and references to “you”, “your” or “Builder” and “we”, “our” or “Zus” refer to you or us in the same way they do in the Builder Terms.

BY SELECTING THE MEDICATION SERVICE IN A BINDING ORDER FORM WITH ZUS, OR BY USING THE MEDICATION SERVICE , YOU AGREE TO THESE MS TERMS, INCLUDING THE SURESCRIPTS TERMS.  IF YOU DO NOT AGREE TO THESE MS TERMS, YOU MAY NOT USE THE MEDICATION SERVICE.

All capitalized terms used but not defined in these MS Terms shall have the meaning set forth in the Builder Terms.

A. Definitions

“Data Source” means all PBM Data Sources and Pharmacy Data Sources and any other third-party data providers, such as health plans, that have entered into written agreements with Surescripts, either directly or indirectly, in order to allow access through the Surescripts Network to information in its possession.

“Medications Service” means the API made available by Zus to provide medication services for your Patients from one or more Zus Network Partners, including Surescripts, LLC (“Surescripts”).

“Participants” means any Data Sources, prescribers, health care providers, and facilities, technology vendors, and other entities and individuals that have entered into written agreements with Surescripts, either directly or indirectly, in order to access, provide, or communicate through the Surescripts Network.

“PBM Data Source” means a pharmacy benefit manager, health benefit payer or administrator, or other similar entity which has entered into a written agreement with Surescripts to allow access through the Surescripts Network to information in its possession.

“Pharmacy Data Source” means a pharmacy, pharmacy chain, or Surescripts-certified aggregator that aggregates information on behalf of pharmacies, or other similar entity which has entered into a written agreement with Surescripts to allow access through the Surescripts Network to information in its possession.

“Prescriber End User” means an individual, located in the United States or a United States territory, that (i) is employed by, an active member of the medical staff of, or otherwise permrning healthcare services as a legally authorized representative of a Builder; and (ii) if required by Applicable Law to be licensed, registered, or otherwise authorized with the appropriate Governmental authority to perform the applicable healthcare services that has been issued a National Provider Identifier (“NPI”) by the appropriate governmental authority.

“Surescripts Data” means any data or information relating to Surescripts, or its services or operations, provided to you or your Prescriber End Users by or on behalf of Surescripts, including statistics collected by Surescripts regarding transactions processed by the Surescripts Network, test data, test cases, configuration information, and problem description and resolution information.

“Surescripts Network” means the Surescripts proprietary technology for secure, nationwide, interoperable health information infrastructure between Participants.

“Surescripts Service” means the services provided by Surescripts using its proprietary technology for secure, nationwide, interoperable health information infrastructure, as incorporated into the Medications Service.

“Surescripts Terms” mean the Surescripts required terms and requirements set forth in Section C below.

B. General Medication Service Terms 

1. Use of the Medication Service. The Medication Service is one of the Builder Services available through the Zus Platform and is delivered by Zus pursuant to the Builder Terms.  Your use of the Medication Service is subject to and conditioned upon all applicable terms and conditions of the Zus Builder Terms of Service and these Medication Service Terms, including the Surescripts Terms in Section C below.
2. Fees.  Your use of the Medication Service is conditioned upon payment of fees identified in the applicable Order Form you accepted or executed with Zus.
3. Notice of Partnership Termination.  We will notify you in writing in advance of the effective date of any expiration or termination of our agreement with Surescripts such that the Surescripts Network and Surescripts services will no longer be available to you through the Medication Service as of the effective  date of termination or expiration.
4. Support. Zus will provide customer support for you and your Prescriber End Users. Such support will include, without limitation, taking initial inquiries from locations, diagnosing the nature of any problems, and resolving such problems where possible, prior to contacting Surescripts to assist in such resolution.

C. Surescripts Required Terms & Requirements

1. Confidentiality. You and your Prescriber End Users will keep confidential any Surescripts or Participant proprietary and/or confidential information.
2. Prescriber Authorizations.  You represent and warrant to us that you have obtained all necessary authorizations from your Prescriber End Users required to permit Surescripts to use all information provided through the Medication Service.
3. No Modifications or Reconfiguration.  You may not, and you may not allow your End Users to: (a) modify, change, or otherwise alter any component of the Medications Service that you use to connect to the Surescripts Service without first providing written notice to Zus and, if necessary, working with Zus to obtain Surescriptions certification of such modification or change; or (b) reconfigure or disable any portion of the Medications Service or Surescripts Service.
4. Access on behalf of Prescriber End Users Only. You may only use the Medication Service to connect to the Surescripts Network on behalf of Prescriber End Users.   You may not (i) use the Surescripts Network in any manner which would allow the general public access thereto; or (ii) authorize any use of the Surescripts Network for the benefit of any person or entity not a Prescriber End User.
5. Permitted Use for Treatment Purposes Only.  You and your Prescriber End Users may only use or access, or attempt to use or access, the Surescripts Service in connection with and in conjunction with treatment of a specific patient in conjunction with a patient event in a healthcare setting. For purposes of the Medication service, “treatment of a specific patient in conjunction with a patient even in a healthcare setting” has the same meaning as the term “Treatment” under HIPAA (45 CFR 164.501).
6. Management of Prescriber End Users.a. Definitional Requirement. You will designate a Prescriber End User for the Medication Service (i) only after confirming that such individual or entity meets the definition of a Prescriber End User set forth in these Medication Service Terms, and (ii) only subject to ongoing satisfaction of the identity-proofing and other requirements set forth in Subsection 6(b) below.

   b. Identity Proofing. You will conduct identity proofing and user authentication sufficient to meet regulatory requirements and industry standards to confirm that messages transmitted through the Medication Service originate from Prescriber End Users who are licensed to use the Medication Service, pursuant to these MS Terms.

7. Commercial Messaging Rules.a. General Limitation. You may not, and you may not allow your Prescriber End Users, to use any means, program or device, or permit any other person to use any means, program or device, including not limited to advertising, instant messaging, and pop-up ads, to influence or attempt to influence, through economic incentives or otherwise, the prescribing decision of a prescriber at point of care if (i) such means, program, or device is triggered by , initiated by, or is in specific response to, the input, selection, and/or act of a prescriber or his/her agent prescribing a pharmaceutical or selecting a pharmacy for a patient; and (ii) that prescription shall be delivered via the Surescripts Network.

   b. Exceptions to General Limitation. Notwithstanding the provisions in Section 5(a) above, you may (i) show information regarding a payer’s formulary and benefit plan design, including patient lowest cost options, on/off tier, prior authorization, step therapy, coverage status, and co-pay information; and/or (ii) deliver or have delivered to Prescriber End Users clinical alerts that are sourced from payers and/or attributed to generally recognized and reputable sources providing clinical information to the prescriber, even if, in the event of either (i) or (ii), such information influences the patient or prescriber’s choice of pharmacy or other prescribing decisions. In addition, in the event of either (A) or (B) above, you will (i) allow your Prescriber End Users to access all pharmaceuticals known through generally available sources used in the industry, and all pharmacies, including retail and mail service pharmacy options available; and (ii) not be designed to preclude a physician or patient from selecting any particular pharmacy or pharmaceutical.  Any custom lists created and maintained by Prescriber End Users with a Builder software product, including but not limited to: (aa) an individual Prescriber End User’s most often prescribed medication list; (bb) an individual Prescriber End User’s most often used pharmacy list; and/or (iii) an individual Prescriber End User’s most often used SIGs (i.e., instructions for the use of medications), would not be considered a violation of this Subsection (C)(7).

8. Patient Consents and Authorizations. As a condition of using the Surescripts Service, you are responsible for obtaining any patient consents and/or authorizations required by Applicable Law and to ensure that your Prescriber End Users have certified to such.  You will ensure that such patient consents and authorizations allow disclosure of all elements of data to be exchanged, requested or intended.  You will require that each Prescriber End User obtain the consent of the patient prior to requesting medication history services for such patient.
9. Additional Surescripts Requirements.  You may only use and access the Surescripts Service if you meet the following additional requirements:a. Access to and Use of the Surescripts Network.  You may only use the Surescripts Service in accordance with the terms and conditions of these Medication Service Terms, including the Surescripts Terms.

   b. Adherence to Applicable Law and Commercial Messaging Rules.  You will comply with all the provisions of the Zus BAA and Applicable Law, including obtaining all necessary patient consents and authorizations and the Commercial Messaging Rules, in accordance with these MS Terms.

   c. Surescripts Disclaimers.

   i. Availability of Data Sources. Surescripts makes no representation or warranty regarding the availability through the Surescripts Network of any particular Data Source or other participant in the Surescripts Network.  At any time, Data Sources or other Participants in the Surescripts Network may be added to or deleted from the Surescripts Network or may limit your access to their data, such charges may occur without prior notice.

   ii. Limitations of the Surescripts Network. Surescripts uses available technology to match patient identities in order to provide the Surescripts Service in accordance with these MS Terms.  Because patient information is maintained in multiple places, not all of which are accessible to Surescripts, and because not all patient information is kept in a standard fashion or is regularly updated, it is possible that false matches may occur or that there may be errors or omissions in the prescription benefit and/or medication history information provided pursuant to the Surescripts Service.  Therefore, it is the responsibility of any treating physician or other health care provider or facility (not the responsibility of Surescripts) to verify prescription benefit or medication history information through other means with each patient and/or the patient’s representatives before such information is relied upon or utilized in diagnosing or treating the patient.  Surescripts is not a health plan, health care provider or prescriber.  Surescripts does not and cannot independently verify or review the information transmitted through the Surescripts Network for accuracy or completeness.  Pursuant to the foregoing, you acknowledge that, and you shall cause each Prescriber End USer to acknowledge, the prescription benefit and medication history information provided hereunder is not complete or accurate, and that neither Surescripts nor any Data Source provides any representations or warranties with respect to the accuracy or completeness of the prescription benefit or medication history information from any liability, cause of action, or claim related to the completeness or lack thereof of the prescription benefit or medication history information.  In addition, you will require that Prescriber End Users confirm the accuracy of the prescription benefit and medication history information with his/her/its patient prior to providing any medical services based thereon, and that Prescriber End Users will use his/her professional judgment in the provision of care. You agree that Data Sources will be third-party beneficiaries of this Subsection.

   iii. No Substitution for Written Prescription or Documentation. The Surescripts Network is not intended to serve as a replacement for (a) a written prescription where not approved as such by the appropriate governmental authorities where such written prescription is required for record keeping purposes; or (b) applicable prescription documentation.  Use of the Surescripts Network is not a substitute for a health care provider’s standard or professional judgment.  Any decision with regard to the appropriateness of treatment, or the validity or reliability of information, is the sole responsibility of a patient’s health care provider.

10. Surescripts Data Sources.  Any Data Source, in its sole discretion, may elect not to receive prescriptions and other messages pursuant this Medication Service from any Prescriber End User.
11. Audit by Surescripts. You will allow Zus or Surescripts to access, inspect, and audit your records relating to use of the Surescripts Network, Surescripts Data, and data or information provided by Participants.
12. Surescripts Materials.  At your request, we will make available to you any Surescripts Materials (subject to all applicable confidentiality requirements) and you will comply with them.
13. Use of Data. You may not make any use or disclosure of any data or information provided by Data Sources by or through the Surescripts Network except for treatment purposes as described in Section (C)(5) of these MS Terms.  Additionally, you will not attempt to capture, open, examine, modify, add commercial or other messages to, repackage, distribute, license, sell or make any commercial use of any data or information provided by any Data Source by or through the Surescripts Network other than as specifically permitted in these MS Terms. By way of example, you may not retain a copy of, store in any medium, perform analytics on, aggregate in any manner, or otherwise perform any action with relation to any data or information sent through the Surescripts Network other than as specifically permitted under these MS Terms.  Except as specifically set forth in these Terms, you will act solely as a passive conduit of information sent through the Surescripts Network. You will engage in no act or omission which would interfere with, modify, or delay the transmission of any data or information provided by the Data Sources which is communicated through the Medication Service. Nothing in these MS Terms shall restrict use of data or information provided by Data Sources and obtained or sent through the Surescripts Network once such data or information has become part of a patient’s permanent record.